Provider Demographics
NPI:1275008468
Name:JENNIFER BUNDY DDS PLLC
Entity Type:Organization
Organization Name:JENNIFER BUNDY DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-DENTAL OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-948-1720
Mailing Address - Street 1:8440 E. MCDONALD DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250
Mailing Address - Country:US
Mailing Address - Phone:480-948-1720
Mailing Address - Fax:480-948-3150
Practice Address - Street 1:8440 E. MCDONALD DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250
Practice Address - Country:US
Practice Address - Phone:480-948-1720
Practice Address - Fax:480-948-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty